Background Check Requirements for Home Care Workers in Georgia

Long-Term Care Background Check Program. O.C.G.A. § 31-7-350 et seq. (HB 987, fully effective October 2021) requires fingerprint-based state (GCIC) and FBI checks for owners, applicants, and direct access employees of licensed facilities including private home care providers and home health agencies, processed through the Georgia Criminal History Check System (GCHEXS). Source ↗

Registry checks. GCHEXS determinations incorporate checks of the Georgia nurse aide registry, the state sexual offender registry, and other required databases before a fitness determination is issued. Source ↗

Fitness determination. The Department of Community Health issues a satisfactory or unsatisfactory determination; individuals with disqualifying crimes (e.g., abuse, neglect, exploitation, violent felonies under O.C.G.A. § 31-7-350) may not work in direct access roles unless they obtain a waiver/fitness reconsideration. Source ↗

Pre-2021 hires. Employees hired before the effective date were grandfathered against re-fingerprinting at the same employer, but a change of employer triggers a new GCHEXS check. Source ↗

No universal federal mandate. There is no federal law requiring criminal background checks for private-pay home care workers; requirements are set state by state. HHS OIG found wide variation in state home health background check requirements, and Medicare Conditions of Participation for home health agencies defer to state law on screening. Source ↗

National Background Check Program (ACA Section 6201). Section 6201 of the Affordable Care Act created the CMS National Background Check Program, which awarded grants to more than 25 states to build fingerprint-based, comprehensive background check systems for direct patient access employees of long-term care providers, including home health agencies and personal care providers. Source ↗

FCRA obligations. When an agency uses a consumer reporting agency (third-party background check vendor), the federal Fair Credit Reporting Act requires a standalone written disclosure, the applicant's written authorization, and the pre-adverse action / adverse action notice process (copy of the report and Summary of Rights) before rejecting a candidate based on the report. Source ↗

OIG exclusion list (LEIE). Home care providers that bill Medicare or Medicaid must not employ or contract with individuals excluded from federal health care programs. HHS OIG maintains the List of Excluded Individuals/Entities (LEIE); CMS and state Medicaid agencies expect screening at hire and monthly thereafter, and payments tied to excluded persons are subject to recovery and civil monetary penalties. Source ↗